BCBS of IL-dr. supv. diet requirement

Laura A.
on 10/24/09 11:58 am
Hello all, I am going to call my insurance on Monday after my psych eval., but in the meantime, do any of you know if Blue Cross Blue Shield of IL requires a 3 or 6 month dr. supervised diet and exercise program?  I have heard both; someone told me they just changed in Sept 09 to a 3 month requirement. Thank you!
Teresa C.
on 10/24/09 1:06 pm

The insurance companies seem to change policies often.  I have BCBS of Michigan and currently I have to complete 6 months supervised diet.  I began the first of this month.  I inquired about a 3 month more intensive program but was told that was not available with my insurance.  I wanted to have it for the new year but suppose I'll have to wait :
Good luck with your journey.

Teresa AKA tjcteacher

                
Laura A.
on 10/25/09 3:29 am
thanks!
born2bfit
on 10/25/09 4:36 am - Lansing, MI
that is so interesting..my co worker has BCBS of Michigan and was told she did not need the 6 month diet. And has never done one of these. She was told they were no longer requiring it and was approved without it. 
Teresa C.
on 10/25/09 5:17 am
REALLY!  When was she approved?  Has she had the surgery-who is her surgeon-I want it now!  but i don't have the money for self-pay.  I have BCBS of Michigan and it's a PPO-I am supposed to have the "cadillac" of insurances.  I want somebody to figure it out fom me.  Supposedly the sugeon's office contacts them.  What is her name?  is she on the OH?
Thanks Teresa

Teresa AKA tjcteacher

                
born2bfit
on 10/25/09 6:12 am - Lansing, MI
she hasn't had her surgery yet because she still has to jump through the hoops.  We went thru the info class together but she got to start jumping thru the hoops (dietician, psychologist and all of that) before me because I had to wait on my insurance..hers was instant approval because her BMI was over 40..mine was under and i have PHP so i had to wait for approval.  We are going thru Sparrow Hospital Weight Management..she is supposed to be signing up for OH soon..she has been looking around and asked on friday for my OH name so she could friend me.

In our cases, we went to the class and then I had to gather all my medical documentation which the management clinic submitted to my insurance company for me..they told me what i needed.  In her case, they jjust got approval without her having to submit itt all because they said that basically BCBC of Michigan just requires a BMI of 40 and she's all set.
Teresa C.
on 10/25/09 8:03 am

I attended a seminar in September.  The first of October I had appointments with dietician, psych exam, blood test, a test to determine metabolism and I've met with my primary doctor.

Teresa AKA tjcteacher

                
Teresa C.
on 10/25/09 5:22 am
I also went to WW for 2 years ---'01-03' but that was 6 years ago and I don't think that counts since it's more than 5 years ago.  the insurance stuff does not make sense to me-I just want to talk with an insurance person and for them to approve it.  I weight 240 at 5'6" And have High Blood Pressure, arthritis, pre-diabetic, and high bad cholestral and low good.  I certainly qualify.

Teresa AKA tjcteacher

                
Teresa C.
on 10/26/09 11:37 am
I called the insurance company again today to verify the 6 month supervised diet and I still have to complete it.  It is waived for those over 50 BMI.  I am 39 BMI with Comorbities so I don't qualify.  But the surgery is covered after the 6 months so it will be springtime for me :)
unless they change it in January

Teresa AKA tjcteacher

                
born2bfit
on 10/25/09 6:16 am - Lansing, MI
I see your doctor is out of kentucky and yet you have BCBS of Michigan...are you planning to travel for surgery?
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